Best Practices Project

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In January 2016, the West Virginia Attorney General's Office joined a number of attorneys general in urging the CDC to adopt guidelines for prescribing opioid painkillers. The guidelines provided guidance to doctors to better evaluate the potential benefit and harm of prescribing opioid painkillers.

Our office has taken these guidelines and gone a step further – drafting best practices on a local level in a first of its kind collaboration for the Mountain State.

The Attorney General's Office has developed a Best Practices Toolkit for all channels of the pharmaceutical supply chain to curb the prescription pill epidemic. We collaborated with groups involved in the prescription drug supply chain, including pharmacies, doctors, manufacturers, and wholesalers, to develop, refine, and implement new best practices. The goal is for all groups to work together to ensure the safe and appropriate use of opioids when treating patients while also minimizing the risk of addiction and substance abuse.

Our goal is simple – help patients experience the relief they need without the risk of becoming addicted to a drug that shares many characteristics with heroin.

Through use of our best practices, we seek to dramatically reduce the use of opioids as a first-line therapy in pain treatment. This means we must significantly increase use of non-opioid alternatives and empower patients to question the necessity of any opioid prescription they receive.

The initiative offers recommendations for prescribers and pharmacists so as to reduce misuse, while preserving legitimate patient access to necessary treatment.

The guidelines urge pharmacists to verify the legitimacy of each patient, prescriber and prescription, in addition to ensuring the medication, dose, quantity and any mix thereof is safe and appropriate.

Likewise, prescribers are encouraged to regularly monitor their patient’s use of opioid drugs; utilize physical exams and urine tests to spot evidence of misuse; and educate each patient about the risks of opioid treatment, only then approving such a prescription after a screening and consideration of non-opioid alternatives.

The best practices initiative further urges both professions to expand the use of West Virginia’s prescription drug database; educate patients about safe use, storage and disposal of opioid drugs; and incorporate naloxone into opioid treatment discussions.

When opioids prove appropriate and necessary, the initiative seeks to ensure these highly addictive painkillers are prescribed and dispensed at the lowest effective dosage rate, consistent with expert medical advice.

The initiative applies exclusively to adult patients and does not impact those suffering pain associated with active cancer treatments or palliative and end-of-life care.